CVP动脉灌注联合手术治疗晚期上颌窦鳞癌的疗效(附39例分析)

Treatment of squamous cell carcinoma of maxillary sinus with a CVP chemotherapy through arterial injection

目的 :探讨CVP方案行颞浅动脉灌注术前诱导化疗联合手术治疗 39例晚期上颌窦癌患者的可行性。方法 :39例T4患者采用卡铂、足叶乙甙、平阳霉素诱导化疗 ,然后施行上颌骨扩大切除加同侧根治性颈淋巴清扫术。结果 :所有患者均可耐受化疗 ,化疗疗效评价均为部分缓解。术后失访 5例 ,随访资料完整 34例 ,占87%。所有病例无原发灶复发。其中 4例死于远位转移 ,分别为术后第 5月、第 7月、第 8月和第 12月。 30例无瘤生存。 5年以上 17例 ,3年以上 6例 ,1年以上 4例 ,不足 1年 3例。结论 :CVP颞浅动脉灌注术前诱导化疗联合手术治疗晚期上颌窦癌 ,是提高远期疗效的有效方案。合理的术后化疗及免疫治疗是减少术后远位转移 ,提高远期生存率的重要因素。

Objective: To analyse the effects of CVP chemotherapy through arterial injection (CVPC) in the treatment of squamous cell carcinoma (SCC) of maxillary sinus.Methods:39 cases of primary squamous cell carcinoma of maxillary sinus at stage Ⅳ (M0) were treated with following regimen : carboplatin 300～350 mg/m 2 ia gtt on d1, etopside 100 mg ia gtt on d1～5, pingyangmycine 8 mg ia gtt on d1～5. The drugs were given through superficial temporal artery at the level of internal maxillary artery. Gave one cycle treatment before operation which was practised 4 weeks later.Results:Partly remission was found in all patients after chemotherapy. Pathological margin of original focus was negative after operation. 5 cases lost follow up. 4 cases were dead of distant metastasis (after 5,7,8 and 12 months respectively). 30 cases were alive without tumour. 17 cases were over 5 years, 6 over 3 , 4 over 1 and 3 less than one year.Conclusion: CVP arterial injection chemotherapy is effective in the treatment of SCC of maxillary sinus at late stage.